| NPI | 1982011763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 273667) |
| Additional Taxonomies | 202K00000X Phlebology (Licence: MA 273667) |
| 208M00000X Hospitalist (Licence: ND 14809) | |
| 208M00000X Hospitalist (Licence: MA 273667) | |
| Enumeration Date | 2014-07-14 |
| Last Update Date | 2022-04-29 |